Grimoire Diabolique

THE DRITIPHILIST

“I have this… problem,” he admitted.

“Believe me, everyone who’s ever sat in that chair has a problem,” related Dr. Marsha Untermann. “Not a typical problem but a grievous one. A problem so incalculable—and so aberrant—that it rocks the imagination.” The woman’s gaze thinned. A long elegant finger traced a graceful chin. “You’re here for a reason—your own rehabilitation. You’re scared. You’re scared that I might find your ‘problem’ so deviant or absolutely appalling that I will insist that you leave my office at once and never come back.”

Nougat-brown eyes leveled at him.

“Yes,” he croaked. “I’m… very afraid of that.”

“Because if that happens, you’ll have nowhere to go?”

“Yes,” he said.

“You probably think that there is no one else in the world like you. That’s why you’ve refrained from seeking help in the past, correct?”

“Yes.”

Dr. Untermann leaned back in the chair behind her desk. She smiled as thinly as her gaze. “Then your fears are without foundation. I do not turn patients away, however foul their problems—or their crimes—may seem. It’s my job. I do my job. And I think I can safely say that this ‘problem’ of yours?” She lit a long cigarette and shook her head. “I’ve heard much worse.”

The smoke spewed from her lips like a ghostly fluid. Her eyes opened wider, inquisitive, coldly promising.

“Tell me about this problem of yours,” she said.

Barrows’ suit cost more than the average resident of Seattle earned in a month. As an investment banker for Jenkins, Harris, & Luce, he could afford it. He could afford the Aston Martin Zagato with the turbo’d 5.3-liter V8, he could afford the Movado gold watch, and he could afford the waterfront penthouse suite on Alaskan Avenue.

One thing he could not afford, however, was to allow anyone of import to see him—

Well…

Better to put it this way. If Barrows made $500,000 in one year—that was a bum year. Investment banking involved a certain alchemy of which Barrows possessed the cabalistic necromancer’s wand. Objectively, his profession entailed moving clients’ money from one bank to another, which sounded simple. In truth, though, knowing where and when to move the money, and for how long, was what made his clients and himself preposterously wealthy. In other words, William Barrows had a reputation to maintain, a reputation upon which his financial solvency depended.

Already out of place in the Armani suit, he walked slowly down the sidewalk past the county courthouse on Third Avenue, right alongside the bums and drug addicts wandering in their plight to a stinking nowhere. Yet Barrows scarcely saw them. He walked steadily onward, his eyes roving the sidewalk’s cement for…

His heart jumped when he heard the sound…

The sound of a man clearing his throat and expectorating loudly.

The ever-familiar splat on the sidewalk came next, and next after that came Barrows’ nearly full erection. Up ahead, he saw it. A derelict in filthy beard and rotten clothes had coughed up a wad of phlegm from his homeless-roughened lungs, and spat it on the sidewalk.

Oh, God, Barrows thought just as a normal man would think upon entering the bedroom of a beautiful woman for the first time, or watching that risky bond fund skyrocket and split.

Barrows caught the glint: a lumpen gem. It lay there waiting for him, freshly green, savory and mystical. Barrows’ Guccis clicked up and stopped, and now he was standing there, feet apart, over the treasure.

He was discreetly protecting it from haphazard trample.

For someone to walk on it would be vandalism. It would be yanking the needle from an addict’s vein and cruelly emptying the syringe out the window. Barrows was guarding it, in other words, while at the same time trying to appear normal.

He glanced at his watch, frowned like a Straussberg method actor waiting for a bus; he was Hitchcock in a phone booth. He had to be careful. He could not allow himself to be seen doing what he was about to do.

He waited, calmly tapping his foot. Eventually the pedestrian traffic broke: no one coming down the block from either side.

Oh, God…

Like magic, then, Barrows produced the two index cards from his suit pockets. He knelt very quickly, scooped up the lump of phlegm in the cards, then turned and walked briskly back up the sidewalk.

He ducked behind one of the courthouse’s high brick pillars. No one was there.

Thank you, God…

Then he licked the hock of phlegm off the card, sucked it around in his mouth like a delectable raw oyster, and swallowed it whole.

He closed his eyes, stood as if paralyzed. He felt the still-warm phlegm sink to his gut, and then he signed in bliss, similar to the bliss felt by a crack addict after the first hit of the day off the pipe.

This was Barrows’ rush—not cocaine, not heroin, not sex nor drink nor gambling.

It was phlegm.

Hence was his plight, the macabre curse which had held him captive for most of his adult life. Barrows was a phlegm-eater.

He couldn’t help it, and he never knew why.

This is so wrong, he thought every time he scraped up a lump and ate it. What seemed even more wrong was what followed after he swallowed: a titan sexual surge. Most times he was able to contain himself until he got home, other times no. Other times he’d slink into a urine-fetid alley or between a high bank of bushes, to vigorously masturbate.

Seeing phlegm on the street lit a oracular fire in him. It nearly stripped him of all sanity, of everything that could be called healthy.

Barrows had to have it.

He had to eat it.

Picture a person stumbling across the desert. This person has not drunk water in days. Suddenly that person, close to death, happens upon a clear cold babbling brook…

To Barrows, the babbling brook was sputum. The dirtier the better. The more catastrophically disgusting, the more he’d need it. Homeless bums were best, the people literally rotting in the alleys, hacking up clumps of respiratory discharge from soiled and emphysematic lungs. Virtual wads of congestion. Sometimes the chunks were coppery with blood, or uniquely textured by bits of cancerous lung tissue. Sometimes the clumps contained mysterious grit.

All the better for Barrows.

He had to have it. He had to scrape it raw off the sidewalk and eat it, hoping no one would bear witness. He could imagine the reaction of an associate partner walking down the street one day and seeing Barrows scarfing bum phlegm. He could imagine what the firm’s president might say upon hearing of this. With every day that went by, and with every chunk of some rummie’s hock that he ate, Barrows knew he was living on borrowed time.

Once a Seattle cop had seen him, and though Barrows could not conceive that eating phlegm off the sidewalk violated the law, he was grateful that the constable had received a call on his radio at the same time. Barrows did not want to have to explain what he was doing. A number of homeless had seen him too, but he needn’t explain to them.

Sometimes he paid the dregs of the local prostitutes to cough into his mouth. Sometimes he’d walk right up to paralyzed bums rotting in alleyways and pay them $100 to drag up a giant loogie and hack it up into his hand, after which he’d eat it like a culinaire savoring Nicouli ossetra caviar off of toast points. Once he’d paid an obese homeless woman on Jackson Street to cough up a big one into his mouth. She’d smelled worse than anything Barrows’ olfactory senses had ever experienced, but she’d obliged and then some, hacking up a blob of phlegm the size of a baby’s fist. When Barrows had rolled it around on his tongue, he’d found a rotten tooth, which he’d swallowed with the rest of the prize.

Bums and whores and Seattle’s constant human street detritus were one thing, but he knew he had to be careful, more careful than he’d been in the past. He couldn’t have people on the street recognizing him, oh no, not with his picture constantly in the state market news, not with his picture in Forbes and the financial trade magazines. But too often it seemed that the longer this grotesque curse went on, the more he became lost in it.

With every glob he slurped down, he realized how wrong it was, how demented and abnormal. And for the two decades that had transpired since his first indulgence at age twenty, he’d always assumed that his sickness was so remote, and so insulated, as to be totally exclusive to himself.

What could he say to his doctor? What could he say to a shrink? I have this problem, see? I have to eat phlegm.

No, no. He could not say that, because he couldn’t believe that anyone else on the surface of the earth could be stricken with such a bizarre and filthy addiction.

Barrows, in his curse, felt alone in the world. Until—

He’d been hunting for a fresh wad, after work as usual, stalking the most rank warrens of Third and Yesler—the “Bum” district. Damn it! came the desperate thought. He itched, junkie-like, when he saw the droves of people milling up and down. The Kingdome loomed, reminded him that baseball season was in full swing; the extra pedestrians would make his travail all the more difficult.

Wait, he thought.

No other choice.

Barrows ducked under the pillared cover of the King County Courthouse, amongst a coterie of employees out for a smoke break.

He stood there for hours.

Waiting.

By eight p.m., he was cross-eyed in his need. His fingernails had dug crescent gouges into the meat of his palms, and his face felt was slicked with sweat. He watched the whores flit by across the street, each of whom would be grateful to hack into his mouth for a C-Note; he watched the bums straggle, spitting their precious wares onto the sidewalk.

Too far away for Barrows to claim.

The sun sunk. He came close to chewing a hole in his lower lip as he waited. Then—

An obese, bearded man in a wheelchair (wearing a plaid dress, of all things [but this was Seattle]) rolled by and hacked loudly. A wad of blackish phlegm landed only feet before the place where Barrows stood.

Barrows’ heart picked up.

He ducked out, an index card in each hand. Anxious glances up and down the street showed him meager pedestrian traffic.

He scooped up the wad, walked to the big brown garbage can behind the bus stop, then knelt as if to tie his shoe.

He didn’t tie his shoe.

His lips pulled the fresh lump off the card. He sighed as his tongue squashed the briny lump between his tongue and the roof of his mouth. He savored and swallowed.

Jesus…

It was all he could do, then, not to stick his hand right down into his pinstriped Italian slacks and beat himself off. His knees wobbled at the rush. He was fixing as the lump went down.

Jesus God…

When the rush lifted, and his vision cleared, he heard a scuff to his left. The bus shelter, he thought but hardly cared. Suddenly, though, the sidewalk was vacant, and in the bus shelter, he saw—

A tall, haggard man, another “bum.” Jeans smudged black with dirt, long hair, beard flecked with bits of food and boogers. The back of his dun-colored jacket read KING STREET GOSPEL HOMELESS SHELTER, and he was doing the most unusual thing:

He was—

What the…

With a piece of cardboard, he was scraping up a pile of vomit in the bus shelter; in fact, he was scraping it up rather meticulously.

The vomit looked like chunky pink oatmeal.

Then he flapped the granular puke into a plastic Zip-Loc bag. He craned his long neck, caught Barrows staring at him.

A snarl like an animal, then the man away, carrying his plastic bag full of bum vomit with him.

“That’s when I knew it,” Barrows admitted to Dr. Untermann. “When I saw that guy—that bum—scraping up the vomit off the sidewalk and carrying it away…” He closed his eyes, rubbed his temples. “That’s when I knew—”

“That you weren’t the only one with a severe and incomprehensible problem,” Marsha Untermann finished for him. “Hmm. Collecting vomit.”

“Yes. Collecting it, putting it in a bag.” Barrows looked up at the comely psychiatrist. “I don’t even want to think what he does with it later.”

“He probably eats it,” Dr. Untermann bluntly offered. “It’s a form of dritiphily.”

Barrows’ lower lip hung down in bewilderment. “A form of—”

“Dritiphily, or dritiphilia. It’s part of the clinical scope of what we now think of as an OCD—an obsessive-compulsive disorder.” Her manicured index finger raised. “But it’s very rare, to the extent that it’s scarcely acknowledged anymore.” Her finely lined eyes blinked once, then twice. “I’m not quite sure why.”

But Barrows still sat in confusion, facing this elegant, refined woman behind the broad cherrywood desk. What did she say? he thought. “Drit—”

“Dritiphily,” her lightly colored lips reiterated.

“There’s a name for it? There’s a… diagnosis?”

“Yes, er—there was. It disappeared from the diagnostic indexes in the late-sixties. For thirty years there was a listing in the DSM. That’s the shrink’s battle book, the Diagnostic and Statistical Manual of Mental Disorders. But Dritiphily, as a diagnosis, vanished once the later editions were released. Instead, it’s been sub-categorized into some of the newer disorders.”

Barrows felt rocked. “You mean there’s actually… a name… for my… problem?”

“Yes,” she quickly replied. “And you’re rather lucky in that my main office is located in Seattle. Besides myself, there are only two other psychiatrists on the west coast who deal in such afflictions. One’s in L.A., the other in San Diego.”

Barrows paused to look at her—this gracile and unique specialist who had agreed to see him at a rate of $450 per hour. The fee, to Barrows, was pocket change to a typical man. He’d pay anything—anything—for help.

Dr. Marsha Untermann was probably over fifty, sharply attired, graceful in manner, her face calm yet her myrtle-green eyes intense. The straight, shining dark gray hair—cut just above the shoulders—gave her an exotic cast, not an aged one; she was high-bosomed, strikingly attractive. Barrows thought of a Lauren Hutton or a Jacqueline Bissett. He’d found her simply by searching the Department of Mental Hygiene’s website; Dr. Untermann’s office address and number had been the only listing under the CRITICAL OUT-PATIENT/ABNORMAL PSYCHIATRY heading.

To Barrows, “abnormal” was putting it mildly.

“So it was this derelict, this vagabond, that impelled you to contact me,” she said more than asked.

“That’s right.” Barrows still felt tightly uncomfortable by all he’d confessed to. Nevertheless, something about her allayed him, like confessing to a nameless priest behind a screen. And he remembered what she’d told him earlier: I’ve heard much worse. Comforting words to Barrows but still…

How much worse? he wondered. It proved a terrifying question.

“I suspect, by your appearance, that you’re a man of means?”

“I’m rich,” Barrows said with no enthusiasm. “I’m an investment banker.”

“Then you might appreciate this quite a bit. This derelict you saw, this precursor, this piece of human flotsam you saw whisking up vomit from the bus stop… you and he are essentially the same.”

Barrows calculated this.

“You’re rich, he’s homeless and poor. You have the best of everything, he has nothing. Yin meets Yang, the capitalist meets the victim of capitalism. The man plugged in meets the man cast out. The two of you couldn’t be more different from a societal standpoint.” Her lips pursed momentarily. Then she added, “But sickness, Mr. Barrows, is relative.”

Barrows found the point of little use—his selfishness, perhaps. His obliviousness in wealth. “I don’t want to sound callus,” he said, “but I didn’t make this appointment to have you make me feel guilty about being rich.”

“You shouldn’t feel guilty,” she replied. “You should feel accomplished. You should feel proud. You’ve done what most can’t do.”

Barrows found no use in this either, and he was not a man to beat around the proverbial bush. His voice roughened. “I usually make a million dollars a year but I have to eat phlegm off the street. That sounds crazy, but I’m not crazy. I need help. You’re the expert. Don’t patronize me. Help me.”

Her bosom rose as she leaned back in her plush chair. “You’re a dritiphilist, with erotomanic undertones. You eat phlegm and masturbate after doing so—that’s not quite the same as someone who’s an asthmatic or even a schizophrenic. There’s no magic pill for dritiphily.”

“Long-term psycho-therapy?” he frowned. “Is that it?”

“Possibly. But don’t scoff so quickly at behaviorilist science. Freud was quite right in many of his tenets. Most psychological anomalies have a sexual base. And Sartre was right too. Existence proceeds essence. It is our existence, Mr. Barrows, which makes us what we are. Conversely, the inexplicable trimmings of that existence are what cause our mental problems.”

Barrows sighed in frustration.

As the sun set in her Pioneer Square window, the shiny dark-gray hair seemed to glow from behind, like an angel’s aura. But this is one cold bitch of an angel, he thought.

“Let me guess,” Dr. Untermann posed. “You had a normal childhood.”

“Yes.”

“You were raised by loving and well-to-do parents.”

“Yes.”

“And you received an excellent education.”

“Private school and Harvard Yard.”

The woman didn’t seem the least bit impressed. “And this affliction of yours—it started in your late-teens?”

“I was twenty…”

“And your first sexual—or I should say copulative—experience came shortly before that?”

“Nineteen…” Barrows’ eyes narrowed. She was hitting each nail directly on the head, which made him feel better. “You know a lot.”

“Obsessive-compulsive disorders have many objective lay-lines.” She seemed casual suddenly, even bored. “They’re all different but they’re all the same in certain ways. You probably married shortly after college?”

“Immediately after.”

“But you didn’t love her, did you?”

Barrows stalled. At first he was offended that she make such an accusation, but then he remembered that it was true.

“No,” she went on. “You married her because you thought that wedlock—a normal incident—might guide you back to normalcy yourself.”

Irritated, he shirked in his seat. “Yes.”

Dr. Untermann lit another long, thin cigarette. A blur of creamy smoke appeared between her lips then vanished in a blink. “Tell me about the circumstances of your divorce.”

Barrows challenged her. “I’m not divorced,” he said. “I’m still happily married.”

“Mr. Barrows,” she immediately sighed, “if you want to pay me $450 per hour to lie, then go right ahead. I’ll take your money. But that’s hardly productive now, is it?”

His smirk made his face feel hot. He felt like a naughty child. This ice-queen is a real piece of work. “Guess not,” he admitted.

“Your marriage did not return you to normalcy, did it?”

“No.”

“Your ‘affliction’ only increased, and you hid it from your wife until—”

Barrows loosened his collar. “Yes, until she caught me red-handed. She got the flu one week. She…”

“Go on. I’m your psychiatrist, Mr. Barrows. The more you tell me, the more I can help.”

Barrows’ shoulders slumped. “She caught me eating her Kleenex out of the wastebasket. In truth—”

“Yes?”

“—whenever she had a cold or the flu… I loved it.” He rubbed his face in his hands. “All that Kleenex. All that snot and phlegm.” It was like a treat, like a midnight snack.

When Barrows looked back up at Untermann, it was shamefully, between his fingers. But the curt, elegant face remained unchanged. It remained inquisitive, calculating. Not shocked.

He sat back up straight in the leather chair. “How come you’re not disgusted?”

“For the same reason an oro-facial surgeon is not ‘disgusted’ by a critical burn victim. The same reason a dentist isn’t disgusted by an abscess. Your job is ministering to the intricacies of finance, Mr. Barrows. My job treating bizarre and often repellent mental disorders. To me, however, they’re neither bizarre nor repellent. They’re merely disorders.”

Barrows was amazed at her professional detachment… so then he sought to challenge her again, not with lies this time, but with a simple question with which to gauge her response.

“Let me ask you something. May I?”

Coils of faint smoke drifted upward. “Yes, but I’ll only answer if I deem it to be productive toward your therapy.”

All right. By now Barrows couldn’t deny a flirting attraction to her, and this seemed a sorry notion indeed. I’ve just told this woman that I eat phlegm that I pay bums to spit in my mouth. I’m sure she’s just dying to go to the opera with me…

“Earlier,” he faltered to begin, “you said… that you’ve heard worse…”

“Oh, my God yes,” she casually replied. “Mr. Barrows, you’ve come in here thinking that you’re an unspeakable person because of your dritiphily, but believe me, that’s nothing compared to some of the patients I’ve treated.”

“Really?” he said, incredulous.

Dr. Untermann reeled off her list as casually as if reciting scores at a miniature golf match. “I’ve treated zoophiles and scatophiles and pedophiles. I’ve treated Munchausen Syndrome where women really do love their kids but can’t help bringing them to near-death. I’ve treated women with Helsinki Syndrome, who fell in love with the men who tortured them in ways that beggar description. I had a strange ‘pica’ case where a teenage girl unconsciously collected dog stool—she’d carefully dry the stools and consume them—and I had a sexual-septicist once—a man obsessed with masturbating with a handful of his own feces. When I was at Georgetown, one of our case studies was an accountant who would collect used condoms from the alleys in Washington, D.C.’s red light district and eat them; he was operated on over a dozen times because the condoms would inflate with his own waste and cause massive and potentially fatal intestinal blockages. We had another man addicted to eating ‘toe-cheese,’ and yet another man—a Virginia rancher—who could only attain erection by sucking the drool off the lips of cattle.” She exhaled more smoke, unperturbed. “Then we have what we call the ‘packers.’”

“Puh-packers?” Barrows dared.

“Men and women who, behind closed doors, are habituated to filling their rectal and reproductive cavities with—well, with just about anything you can imagine. Hamsters, fish, billiard balls, live snakes, live bullfrogs, wines bottles, garden slugs. You name it. One man from Annandale, Virginia, would blow mealworms into his urethra through a plastic tube. A fourteen-year-old girl from—she was a military dependent from Walter Reed—would insert the tip of a turkey baster into her own urethra in order to repeatedly aspirate air into her bladder. Some people simply like to be filled, Mr. Barrows, for reasons that can never be clinically perceived.Then we’ve got the more common aberrations—the collectors: the gym teachers who collect dirty socks, the custodians who collect used tampons, the fetishists who break into houses and collect undergarments soiled by the so-called ‘skidmarks.’ Pedicurists who keep their clients’ toenail clippings. Doctors who collect pus-drenched bandages, and nurses who collect enema nozzles to secret away back to their homes, to sniff and lick.”

Barrows felt exhausted listening to this, and disgusted. But there was more….

“One of my colleagues at the Clifton T. Perkins Evaluation Center wrote an entire diagnostic paper on a dermatologist who would topically anesthetize appropriate prison patients and, with pliers, squeeze the ‘milk’ out of large moles, and lick it up. During my internship at the psych wing of the Fallaway Med Center, there was a nun who constantly volunteered for duty in places like Calcutta, Karachi, and the Sudan. Her sister superiors alerted us to her problem: she was cleaning the ears of the dying with Q-Tips and sucking off the wax.”

Fuck, Barrows thought.

“Stercoraceous syndromes are actually even more common,” she continued. “People obsessed with human excrement—their own or that of others. Adolf Hitler was said to be a stercoramanic; he liked to defecate on women’s faces—poor Eva Braun, hmm? A reverse syndrome involves the opposite, clearly Freudian: people who can only become sexually aroused while being defecated on. The actual shit-eaters are called coprophiliacs or cacophiles—hence the children’s colloquialism caca. You’d be surprised how many feces-eaters there are in the realms of modern mental disorder.”

Barrows’ head began to feel light from shock.

“We’ve even had a few vomit-eaters,” the elegant woman added went on, “like the derelict you saw at the bus stop. People who can find no sense of actualization without the self-abasement of consuming the puke of strangers—they’re called ‘refluxomanics,’ by the way. And though I’ve never actually met a phlegm-eater before, I’ve read several case files regarding them. So you needn’t feel exclusive, Mr. Barrows. There are, indeed, other people sitting in the same boat as yourself.”

Barrows needed a drink. Bad. Phlegm-eater, he thought. There it was, a single, simple term. “But you also called it… what?”

“Dritiphily—from the Middle English noun drit, meaning something akin to human filth. You see how obscure the base word is? It doesn’t even actively exist in our language any more. But obsessive-compulsive symptomologies do indeed exist within a broad range of clinical verges. Utterly minor to the utterly outré. Your regrettable affliction—your dritiphily—is the most extreme manifestation of the poor soul who must count to ten every time they see a red truck, or must step on every third crack in the sidewalk.”

Even Barrows, in his overall shock, had to take exception. “Paying rummies and sick street whores to spit in my mouth isn’t exactly stepping on sidewalk cracks.”

“Outwardly, no. But inwardly, it’s all rooted in the same inception,” the staid woman replied. “We simply have to identify that inception—in your particular case, Mr. Barrows—and then we’ll disclose the proper avenue of your—”

“My cure?” Barrows said hopefully.

“Yes.”

She turned her hand, raised her rice-paper wrist to cast a glance at her watch. “We still have plenty of time. I think we should go on.”

“All right,” Barrows agreed. “Please.”

“So what have we done thus far? We’ve identified the more intricate manifestations of your dritiphily. We’ve established, through your own self-revelation, that you are habituated to eating phlegm, and that this ingestion is the only thing that permits you to achieve sexual arousal. Yes?”

Barrows didn’t like the sound of that, but he kept reminding himself what he was here for. Hence, his reply: “Yes.”

“Normal childhood, normal upbringing,” she said more to herself. “Not at all uncommon. The bad childhoods, the abnormal upbringings—those are the environmental breeding grounds for the Henry Lee Lucases, the John Wayne Gacys, the Jeffrey Dahmers. But you’re a successful investment financier, not a psychopath, not a serial-killer.”

Thanks, Barrows thought.

“Instead, your anomaly is rooted in between those notions. It’s hidden. It’s secreted away somewhere. Think of a well-crafted clock, but with the tooth of one solitary gear broken. We will find that cog, Mr. Barrows, and we will fix it.”

“You make it sound easy,” his voice grated.

“It may be. How badly to do want to be cured?”

He looked up quickly. “I’ll do anything. Pay… anything.”

“You’re accustomed to throwing money at your problems,” she acknowledged. “But that may not suffice here. Your mind is not a carburetor simply in need of a new gasket. But as your current psychiatrist, I’d be negligent in not informing you of some potential ‘quick fixes.’ There are, for instance, some rather radical treatments not endorsed by the APA, available in South America. Cariothiazine infusions which alter the chemistry of your brain, acupuncture, various aroma- and thermal-therapies. Narco-synthesis and bio-feedback cycles. I’ll admit, sometimes they work, but I can’t recommend them.”

Barrows sat closer to the edge of his seat, wringing his hands. “I’ll try anything, and… I’ll pay. I’ll pay a lot.”

“So you’ve said. One thing I can recommend a bit more than the latter would be an aversion-therapy clinic in Köping, Sweden. Believe me, they’ll cure you of anything—the hard way.”

“I’ll do it!” Barrows nearly shouted at her.

“I don’t suppose that the $30,000-per-month in-patient fee would bother you. But I’ll be honest in informing you that all too often these rather Pavlovian aversion techniques only eradicate one disorder to expeditiously replace it with another.”

“Great. I go from eating phlegm to eating shit? No thanks,” Barrows gruffed. He sat back, hands held out uselessly. “What then?”

“Your best chance for a successful recovery?”

“Tell me!”

Her long fingers idly rolled the cigarette then crushed it out. “Your best chance for a successful recovery stands with what you’ve previously frowned at. Maintained—and expensive—psychotherapy,” she said. “Certainly, I’m aware now that you’re a man of considerable income, and, especially due to the nature of your profession, you may think that I’m merely recommending the option that would most benefit my own financial interest. Therefore, to reduce any such trepidations, I’d be happy to give you a list of other psychiatrists who would be happy to render a second opinion.”

To hell with it, Barrows thought. Her staunch demeanor and cool locution told him enough: She’s it. Where else can I go? Fuckin’ Sweden? Goddamn South America? Besides, at the very least, she was attractive; Barrows, in fact, caught a quick fantasy in his mind: Sucking down a big green loogie and fucking her right there on the desk. Maybe if he put a gun to her head, she’d spit in his mouth. “That won’t be necessary. I want you to treat me. Please.”

“Fine,” she said crisply and leaned forward. She began writing on a small tablet. “For the first month, our sessions will be five days a week, seven if necessary. You’ve told me that you typically embark upon your… need… when you leave work, correct?”

“Yes.”

“So I’ll schedule you for, say, six p.m.? Will that suffice?”

“Yes,” Barrows agreed.

“Instead of stalking down James Street every day after work, you’ll be coming here.” She finished writing, handed him a small slip of paper. “Here’s a prescription for a drug called Hydroxyzine. Ten milligrams four times a day. It will help ease the physical aspects of your dependency. In the meantime, I’ll schedule you at Harborview for a physical: blood tests, histamine counts, and the like, and also your first atropine injection, which helps take the edge off too. Then we’ll set you up for a written battery—MMPIs, TATs and TEDs, the Baley Scales and the Rorschachs—these are tests which might seem frivolous to you, but their conclusions will help me get a better fix on the more systematized aspects of your psychological make-up.”

“I’ll do it,” Barrows said without pause.

“Try to control your urges. You’ll probably fail for now, and that’s all right.”

He took the prescription, looked at it as if gazing upon something dear. For a moment, he wanted to cry.

After all these years, he’d found someone who would help him.

Time to start going back to church, he thought.

Dr. Untermann’s regal face appraised him, and she smiled. “Have no fear, Mr. Barrows. You’ve made the first, most crucial step. You’ve come for help. And I’ll help you. So many other never do that. We’ll see this thing through… and fix it.”

Barrows felt choked up as he stood. “Thank you…” His gaze drifted from her face to the wall behind her, which was covered with degrees and certificates. “You must be… pretty good.”

“Not to sound pretentious, Mr. Barrows, but as for treating cases such as yours, I’m probably the best in the country. Go home now. Think about what we’ve discussed, and envision the end of your affliction.”

“I will.”

“Tomorrow at six, then?”

“Yes…”

“And get that prescription filled tonight.”

“I will.”

She lit another long slim cigarette: long and slim and refined like herself. “Goodnight, Mr. Barrows.”

Misty-eyed, Barrows left the office. Part of his psyche, of course, urged him to head right back down to his hunting grounds and search for the strange, tender morsels of his need.

But not tonight.

Because as he made his exit from the frosty, handsome woman’s office, he realized he was leaving with something he’d never had in the last two decades.

He was leaving with hope.

It was like heroin. It was like high-grade crack or freshly distilled crystal meth. Extreme obsessive-compulsive disorders affected the same neurotransmitters that the most highly addictive narcotics affected. Marsha. Untermann had seen enough victims to know not only this but the ultimate implications.

You always start a patient off with a positive purview—that was essential—but the rest was never easy. Sometimes it was impossible, and Dr. Untermann knew impossible when she saw it.

She knew that Barrows wouldn’t make it.

Her black Bally high heels clicked along the clean cement of the parking garage beneath the twenty-story mirror-faceted Millennium Tower, and it was a nice, new black Mercedes 450 that she slid into. She lit another cigarette—a beastly habit, she knew—but didn’t yet start the engine and leave for her lakeside Fremont condo. Instead…

She thought.

Extreme obsessive-compulsive disorders—OCD’s? Especially the really radical ones?

The trichotillomanics, the aphasics, the dysgeusaics? The success rate was actually so low, it was scarcely worth treatment. It was actually less than the seven-percent success-rate for crack addicts. Much less.

The same went for the disorders akin to dritiphily.

Dr. Untermann had learned much in her nearly thirty years of abnormal clinical psychiatry. She’d learned that some things weren’t worth trying to treat.

She heard the footsteps even before the figure turned the corner. She powered down the driver’s side window.

“I got a lot this time,” a sand-papery voice told her.

“I’m pleased.”

Dirty hands passed in the parcel. Untermann took it and handed the figure a $100 bill. “Thank you,” she said. “See you tomorrow.”

Her purveyor said nothing in response. He simply took the money and walked away. The back of his coat read KING STREET GOSPEL HOMELESS SHELTER.

Untermann gave a hot sigh when she opened the parcel: a paper bag containing a plastic Zip-Loc bag, the one-gallon size. She unzipped the bag, inhaled the aroma, and nearly swooned; the bag was heavy with various vomit. Gritty. Fuming.

Like chunky, pink oatmeal.

No, some things weren’t worth trying to treat. But capitulation was a treatment of its own, wasn’t it? Sometimes you just had to surrender to the incontrovertible truth.

Be who you are, she thought in the ultimate Freudian nod. She flicked out her cigarette. Accept it, and adapt.

That’s what she had done. And it worked. The verity of the soul, however unseemly at times, must always be embraced. Not ignored or fought against.

Embraced.

And now this fox financier, this man Barrows. Smart, successful, rich. And more than pleasing to the eye. When Barrows learned that there really was no cure for his disease, he, too, would capitulate… and the two of them would embrace each other.

Her nipples suddenly stood out beneath the lacy cotton bra and sheer Biagiotti cashmere blouse. Her sex moistened; her teeth ground. In her mind, she saw Barrows forlornly straying the city’s most malodorous streets and alleyways, searching for those all-too-precious nuggets, scraping them up and sucking them down like so many melted diamonds. She saw his trembling lips jacked needily open as unwashed derelicts and dirty, wan whores hacked up veritable collops of meaty phlegm into his mouth. His own uniqueness was all too similar to Untermann’s own.

I’ll show him how to adapt, just as I have adapted…

I’ll teach him how to function, unscathed.

We’ll be who we both really are. Not in social fallacy but in truth.

Two human beings one in the same.

Together.

Dr. Untermann finally started the car and drove out of the parking garage. The bag sat beside her in the fine leather passenger seat. She couldn’t wait to get home—

Oh, yes…

—to eat.